What Are Epstein's Pearls?

"My daughter is three months old. I've noticed very tiny whitish-yellow bumps behind her top gum line where her teeth will eventually grow. I know it's too early for baby teeth, so what's going on? I'm worried."

No cause for concern here. It sounds like your little sweetie's got a harmless case of Epstein's pearls, also known as gingival cysts. These protruding bumps are actually quite common in newborns — the National Institutes of Health reports that 80 percent of babies develop them at one point or another during infancy.

These benign nodules, which range from one to three millimeters in size (less than a tenth of an inch) and appear on the roof of a baby's mouth just behind her gums, are perfectly harmless. Similar-looking cysts can appear in other areas of your little one's mouth, in which case they are known as Bohn's nodules (also benign). These cysts contain epithelial cells (which act as a barrier to keep out dirt and microbes in the environment) as well as mucous membranes. You'll find the same combination in the layers of moist tissue that line your baby's urogenital, digestive and respiratory tracts.

As painful as they may look, Epstein's pearls are painless — good news for your baby (and you).

How do these bumps form?

During the first trimester of pregnancy, the two halves of a baby's jaw and palate begin to fuse together. This often causes mucous membranes to become trapped along the midline within the skin pockets, causing the little bumps you're seeing now.

How are Epstein's pearls diagnosed?

Your pediatrician will examine your baby's mouth to rule out similar-looking conditions like thrush, a yeast infection of the mucous membranes lining a baby's mouth and tongue, or, more rarely, actual teeth called natal teeth, which are present at birth and could be irritating when nursing (for both a mom and her baby), cause injury to the tongue, or present a risk of swallowing.

What is the treatment for Epstein's pearls?

There is no treatment necessary for Epstein's pearls. They generally go away within a few weeks, often dissolving as the result of friction with the nipple while nursing or drinking from a bottle.

Heidi Murkoff is the creator of the world’s best-selling pregnancy and parenting series, What to Expect, that began with What to Expect When You’re Expecting. She is also the creator of WhatToExpect.com and founder of the What to Expect Foundation.

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What to Expect The First Year, 3rd edition, Heidi Murkoff and Sharon Mazel.